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Chronic hepatitis C is a complex infectious disease. In medical circles, this diffuse liver disease has been called the “gentle killer.” This is due to the fact that very often group C hepatitis is asymptomatic (from 6 months or more) and is detected only during complex clinical blood tests.
According to existing statistics, in 70% of cases hepatitis C passes into the chronic stage. Currently, this form of the virus ranks first in the number of infected patients who experience severe complications. When conducting studies in different countries of the world, it was found that in 80% of patients it was HCV infection that was detected.
How long do people live with chronic hepatitis C?
The World Health Organization conducts regular research on the viral infectious disease hepatitis C, the data of which is regularly made public. According to data published in specialized media, as well as on medical Internet portals, today more than 500 million cases of infection with this form of hepatitis have been recorded in different countries of the world.
In higher medical circles, there is confidence that within 10 years the number of patients who develop complications due to hepatitis will increase several times:
liver cancer will be detected in more than 70% of patients;
cirrhosis of the liver will be diagnosed in more than 55% of patients;
the number of cases in which hepatitis C will end in death will increase by more than 2 times (today, 57% of patients from the total number of patients die from cirrhosis, and 43% from hepatocellular carcinoma).
Many people are very concerned about the question: how many years can you live with chronic hepatitis C? The virus of this disease is not a direct “killer”. It contributes to the development and progression of various pathologies that have a detrimental effect on the patient’s body and cause irreversible changes. The male half of the population is more susceptible to this disease – they are several times more likely to develop complications against the background of hepatitis C.
Hepatitis C virus infection can lie dormant in the human body for several years without causing any symptoms or discomfort. In some cases, the progression of this disease can occur after 50 years from the moment of infection. Experts say that with the right supportive care, patients with chronic hepatitis C can live a long life.
At the same time, in some patients, cirrhosis of the liver or other dangerous complications can develop within a short period (10-15 years) after infection with the hepatitis C virus. Alcohol consumption significantly shortens the life of a patient with this form of the disease.
Causes of chronic hepatitis
Despite the active development of the medical industry, at present, most often people become infected with the hepatitis C virus in medical institutions or dental offices.
In most cases, infection occurs during various manipulations in which a healthy person comes into contact with infected biological material:
during injections (intramuscular, subcutaneous, intravenous, droppers);
during a blood transfusion;
during dental treatment;
during the hemodialysis procedure, etc.
The spread of the hepatitis virus in medical institutions occurs due to non-compliance with sanitary and epidemiological norms and rules. Modern medicine determines the main causes of hepatitis C infection, which include the following:
use of other people’s personal hygiene products (toothbrushes, towels, shaving accessories, manicure devices, etc.);
having unprotected sex with an unverified partner;
use of one syringe by intravenous drug users;
visits to underground salons where piercings or tattoos are done in unsanitary conditions;
infection of the child by the mother during labor;
visits to nail and beauty salons in which the sanitization of tools is carried out improperly.
Symptoms of chronic hepatitis
Chronic hepatitis C can exist in the patient’s body asymptomatically for 15-25 years.
At the same time, this disease may be accompanied by the following symptoms:
against the background of a decrease in immunity, patients develop colds and viral diseases;
allergic reactions;
general intoxication of the body;
an increase in the temperature regime (in patients, the temperature may rise slightly, and there may be a strong fever);
chronic fatigue, against which there is a loss of ability to work;
increased fatigue (the patient gets tired even with little physical effort);
headaches, often reminiscent of migraine attacks;
disruption of the gastrointestinal tract;
develop diseases of the genitourinary system;
weakening of liver function;
development of diseases of the heart and blood vessels;
general weakness;
an increase in the size of the liver;
loss of appetite;
frequent nausea;
vomiting reflex;
weight loss, etc.
Diagnosis of chronic hepatitis
Due to the fact that chronic hepatitis C is often asymptomatic, in order to diagnose this disease, it is necessary to conduct a complete examination of the patient, which includes a whole range of manipulations. During the examination of the patient, a gastroenterologist or infectious disease specialist should first of all collect an anamnesis of the disease. The specialist should pay special attention to the method of infection of the patient, for this it will be necessary to collect information about his lifestyle. The presence of symptoms characteristic of this disease will help the attending physician to make a preliminary diagnosis, thanks to which it will be possible to outline a set of upcoming diagnostic measures.
In domestic medical institutions, when diagnosing chronic hepatitis C, modern methods, the experience of leading experts from around the world, innovative equipment and a whole range of clinical studies are used. Since 2000, special tests have been carried out in Russian clinics, the results of which can reveal the presence of the hepatitis C virus in the human body. One such test is “ELISA”, which includes kits that contain HCV virus antigens isolated from non-structural genes. Also noteworthy is the recombinant immunoglobulin test “RIBA”, which uses the same antigens. Both of these tests were designed specifically for the detection of HCV RNA.
Currently, when conducting diagnostics, “ELISA” methods are used, which are approved by the FDA and recommended by them for use. These tests are affordable, so even people with modest financial means can pay for them. They are very often used for the primary diagnosis of hepatitis C, as they are able to determine the presence of antibodies of the virus in the body of a patient who has clinical signs of this disease. Due to the high sensitivity to this viral infection, ELISA tests are used in the examination of patients at risk. A false result of such testing can be obtained when examining patients who are on hemodialysis, who have autoimmune disorders or immunodeficiency.
After testing, it is necessary to obtain laboratory confirmation of the diagnosis. To do this, patients need to donate blood, which will be carefully checked for the presence of antibodies to HCV, as well as for the activity of ALT. These studies are carried out through the use of special reagents and high-tech medical equipment. To obtain an accurate clinical picture of the course of this disease, it is necessary to carry out dynamic monitoring of ALT indicators (experts recommend conducting such a study at least once a month). In the event that normal ALT activity is observed for several months, in the presence of HCV antibodies, such patients will be transferred to the group of carriers of the virus.
During laboratory studies of the patient’s biological material, specialists use specific markers.
The results of clinical trials can have the following interpretation:
positive;
uncertain (when such a result is obtained, patients are recommended to undergo a second laboratory examination after 2 months);
negative.
An accurate diagnosis, indicating the presence of chronic hepatitis C in a person’s blood, can be made if HCV RNA is detected within 6 months.
A biopsy can give a more accurate picture of the area of liver damage at the microcellular level. This technique involves a surgical manipulation, during which the biological material of the patient is taken. After that, tissue samples are transferred to the laboratory, where a thorough histological examination will be carried out. Thanks to a biopsy, it is possible to detect cirrhosis, liver cancer and other diseases that are life-threatening for the patient at an early stage of development. When diagnosing patients with chronic hepatitis
With often the following morphological manifestations are detected:
there is a combination of hydropic and fatty degeneration with acidophilic bodies of Councilman;
lymphoid infiltration is detected, against the background of which follicles are formed, the localization of which is the portal tracts;
stepwise necrosis develops;
bile ducts are affected, etc.
When conducting a comprehensive diagnosis, a specialist may indicate the presence of chronic hepatitis C, the development of cirrhosis of the liver, which was preceded by intralobular group necrosis. The attending physician may suspect the presence of this form of the disease when performing palpation of the area in which the organs of the gastrointestinal tract are located. With a change in the size of the liver and spleen, it can be argued that group C viral hepatitis has become chronic.
It is possible to determine the exact dimensions of the affected organs by conducting hardware diagnostics:
ultrasound examination;
CT scan;
Magnetic resonance imaging.
Treatment of chronic hepatitis
After a comprehensive diagnosis and confirmation of chronic hepatitis C, patients should undergo a course of preparation for therapy.
To do this, you must submit:
general and clinical analysis of blood;
general urine analysis;
a blood test for thyroid hormones;
coagulogram;
a blood test for HIV infection, syphilis, as well as other sexually transmitted and infectious diseases.
If, during laboratory tests, a patient has a high level of hemoglobin, then he will need to pass an additional analysis that allows you to determine the indicators of serum iron.
All patients who have been diagnosed with chronic hepatitis C are required to undergo antiviral therapy. In many medical institutions, when choosing a method for treating this form of the disease, they use the recommendations given by the National Institutes of Health and the European Association for the Study of Liver Diseases. They are intended for the category of patients who have been diagnosed with severe or moderate necrotic inflammation. Etiopathogenetic therapy is indicated for patients who have developed liver fibrosis, against which there was an increase in the level of ALT.
The main task of specialists who carry out complex treatment of patients diagnosed with chronic hepatitis C is the eradication of the virus. Thanks to modern methods of treatment and unique medicines, doctors are able to slow down the progression of this disease. Patients who follow the recommendations of specialists exactly, almost immediately after the start of therapy, begin to feel slight improvements. After completing the course of treatment, patients are sent for laboratory examination, due to which the histological picture of the liver is determined.
To achieve good results, the therapy of patients with chronic hepatitis C should be carried out within the walls of a medical institution. Specialized clinics have the necessary equipment and medications that will improve the general well-being of the patient. The advantages of inpatient treatment include the fact that modern medical centers comply with all the rules of the sanitary and epidemiological regime. These patients are treated by highly qualified specialists – gastroenterologists, hepatologists and infectious disease specialists.
A drug course of therapy intended for the treatment of chronic hepatitis C involves taking various medications.:
interferons and other drugs with antiviral action;
azathioprine or prednisolone, as well as other drugs belonging to the category of immunosuppressants;
combined preparations;
pathogenic agents, etc.
Numerous clinical studies conducted around the world have proven the benefits of interferons in the treatment of chronic hepatitis C. These drugs are used in the form of injections that are administered either subcutaneously or intramuscularly. On average, the course of treatment is 12 months, subject to the disappearance of antibodies from the patient’s blood three months after the start of therapy.
The course of treatment with interferons is contraindicated in patients who have the following pathologies:
mental disorders;
depressive conditions;
frequent epileptic seizures;
convulsions;
propensity to form blood clots;
decompiled cirrhosis of the liver;
complex diseases of the heart and blood vessels;
transplanted organs from donors.
In the treatment of the chronic form of hepatitis C, monotherapy is carried out for women in the following cases:
the patient has no problems with being overweight;
the age of the patient has not reached the age of 40;
low concentration of virus antibodies in the blood;
normal iron levels;
minimal changes in the structure of the liver;
elevated levels of ALT in the blood, etc.
In other cases, combination therapy is prescribed for patients with such a disease. During the course of treatment, patients may experience various side effects: anemia, nausea, weakness, dizziness, etc. The course of combination therapy may be delayed for 6 or more months. The duration of treatment will directly depend on the results of a laboratory blood test, which must be carried out at least once a month. In the event that after 1 months from the start of treatment, the results of the tests show no changes for the better, the doctor may change the course of therapy.
The course of treatment for chronic hepatitis C involves taking antiviral drugs.
Such treatment may not be prescribed to all patients with such a diagnosis, since there are a number of contraindications:
pregnancy;
lactation period;
kidney failure;
anemia;
hemoglobinopathy;
diseases of the heart and blood vessels.
In the case when a specialist chooses a treatment method for patients who have diseases associated with hepatitis, a number of additional studies should be carried out. It is very important to achieve the interaction of drugs used in the treatment of chronic hepatitis C and other equally serious diseases.
The modern strategy for the treatment of chronic hepatitis C is a combination antiviral therapy.
Patients are prescribed drugs that interact perfectly with each other (numerous clinical studies testify to this):
ribavirin;
interferon-alpha.
Despite the fact that individually these drugs do not have a strong therapeutic effect on the patient’s body, in combination they do an excellent job with the hepatitis C virus. Individually, these drugs are prescribed only in case of serious contraindications to one of these drugs.
In the treatment of chronic hepatitis C, hepatoprotectors are often used to help restore liver function. Such drugs have a positive effect at the microcellular level, so each specialist includes them in the course of therapy.
Thanks to properly selected drug treatment, specialists manage to prevent the progression of hepatitis. In some patients, after complex therapy, liver functions are completely restored. The duration of treatment depends on the stage of the disease, the general condition of the patient and many other factors.
After the start of drug therapy, the patient must be regularly tested. The first laboratory blood test should be carried out after 2 weeks from the moment you start taking the drugs. The patient submits a biochemical and clinical analysis, the results of which will determine the level of antibodies in the blood serum. The second time a laboratory study of the patient’s biological material is carried out 4 weeks after the start of treatment. Subsequent testing should be carried out once a month. Once every 1 months, patients need to take a blood test to determine the indicators of thyroid hormones, the correct functioning of which directly affects the work of many vital organs and systems of the human body.
If, during the treatment of chronic hepatitis C, the patient began to progress chronic diseases, he will need to get advice from highly specialized specialists. After that, the attending physician will have to correct the treatment therapy, taking into account the recommendations of other specialists.
Diet for chronic hepatitis
In the presence of such a complex disease as chronic hepatitis C, patients need to follow a diet throughout their lives. Thanks to forced food restrictions, the work of the liver can be greatly facilitated. The patient should review his daily schedule, and instead of three main meals (breakfast, lunch and dinner), switch to fractional meals. In this case, the patient will have to eat 6-7 times a day, limited portions. During the diet, the patient must drink plenty of water every day so that all toxins are removed from the body.
In most cases, patients who have been diagnosed with chronic hepatitis C have problems with the gastrointestinal tract, in particular, pathology of the biliary tract develops. Against the background of such changes in the body, patients are strictly forbidden to drink alcohol and alcohol-containing drinks. Experts strongly recommend getting rid of other addictions, such as nicotine and drug addiction.
In chronic hepatitis C, patients should follow a special diet (table No. 5). Patients should not consume the following foods:
fatty meats and fish;
sausage;
Smoked products;
canned meat and fish;
fish caviar;
cheeses;
cream;
fatty dairy products;
chicken eggs in any form;
animal fats;
beans;
hot seasonings;
pickles;
nuts;
meat broths;
carbonated drinks and other products that contain dyes and preservatives in their composition.
The following products are allowed:
dietary varieties of meat and fish;
vegetables and fruits;
vegetable oils;
dried fruits;
vegetarian soups;
natural honey;
porridge;
unsweetened dried fruit compote;
herbal teas, etc.
Complications of chronic hepatitis
Group C hepatitis is a very dangerous disease, against which serious diseases often develop:
liver fibrosis (scars form in the tissues of the liver);
steatosis (fat begins to accumulate in the liver cells);
cirrhosis of the liver (irreversible changes occur in the liver);
encephalopathy (under the influence of toxins, brain damage occurs);
ascites (fluid accumulates in the abdominal cavity);
hepatocellular carcinoma, etc.
Most patients who have been infected with the hepatitis C virus develop dangerous complications:
liver failure;
reduced blood clotting;
pain in the right hypochondrium;
nausea and vomiting, etc.
All products that need heat treatment must be cooked in a double boiler or in an oven with a minimum addition of vegetable oil.